The Implantable Cardioverter Defibrillator (ICD) has revolutionized the treatment of serious cardiac arrhythmias. These devices are often compared to pacemakers and they do share many similarities, however there are many important aspects of an ICD that set them apart from standard pacemakers.

An ICD is used to treat patients with serious, life threatening arrhythmias of the ventricle. Ventricular tachycardia or ventricular fibrillation are serious and difficult to treat. They may cause death, cardiac arrest or fainting (syncope). They are usually associated with underlying heart disease and other treatments (drugs, procedures or surgery) may be required. Before your doctor recommends an ICD you may undergo a variety of cardiac tests such as an EKG, treadmill test, cardiac catheterization or EPS. These may help identify treatable problems, which may contribute to the irregularity of the heartbeat (arrhythmia).

The first ICD was implanted in 1980 and since then the devices have become more complex and more widely used. In the early years ICDs were implanted in the abdominal area because of their size. Patches were placed on the heart and through these patches a shock was delivered to the heart if needed.

Today ICDs are smaller and are often implanted under the skin below the clavicle (collarbone). A lead or wire is passed via a vein into the heart and both paces the heart and allows for shocks to be given if needed to stop a fast heart beat.

The surgery to implant an ICD is performed under sedation and local anesthesia. An incision is made below the clavicle and a lead (wire) is passed into the heart. A pocket is made under the skin for the ICD to be placed. Inducing a rapid heartbeat and allowing the ICD device to treat the arrhythmia and restore a normal heartbeat tests the device. You will spend at least one night in the hospital after the implantation. Once home you will resume normal light activity but avoid lifting or heavy activity for two to four weeks. At one to two weeks after surgery you will need to be seen in the clinic for a wound check and be enrolled in clinic follow-up.

Cardiology Associates provides more information with images on ICD's

Cardiology Associates provides a complete ICD follow-up clinic.

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